IT is now twenty years since HIV/AIDS came out of the shadows. Then, church facilities were among the first to respond to the challenge. Ever since, churches have been deeply involved, with the Catholic Church alone supporting around 25 per cent of all HIV/AIDS care worldwide.
But the epidemic continues to escalate, accompanied by complaints that religious organizations do more harm than good when it comes to HIV prevention. In the past, church hierarchies have tended to react defensively to such accusations. Today though, Christians are dying, clergy are dying, church leaders are dying. AIDS is not just happening 'out there', and to 'other people': at every level, the Church itself is living with and affected by HIV. In recent months, therefore, church leaders have organized a series of consultations designed to revisit their record on HIV/AIDS, and see how they can address the issue more effectively.
The Primates of the Anglican Communion, the Lutheran World Federation in Africa, church leaders of Africa meeting ecumenically with northern partners, the leaders of the Salvation Army in Africa: they have all issued statements acknowledging past failure and committing themselves to change.
HIV/AIDS, they say, is nothing like the world has known: for this epidemic, now, the old ways just won't work. The question is, what next? Churches are complex organizations, and archbishops and bishops are pastors to all their people. The church, particularly in poor countries, has many other problems, and few of its leaders are in a position to drop everything else and focus on AIDS.
They hesitate to say so publicly, but privately many admit that they don't know what to do, they don't know where to start, and they are afraid that if they say anything it may be the wrong thing. The aim of this article is to throw some light on the challenges facing church leaders, as they grapple with the consequences of this new commitment.
2. Saving lives, saving souls
Churches are justly proud of their caring record. However, this caring role has generally been conducted not by the congregations of the faithful, but by professional people doing the job on the churches' behalf. It is a matter of history that the Church has tended to separate its life-saving mission from its soul-saving one.
Thus bishops may raise money for clinics, orphan programmes or hospices, sit on their governing boards, or visit regularly and give the work their blessing: but apart from that, the organization may carry on quietly with its caring role without much interface with local congregations.
Today, though, it is at local church level that the main burden and challenges of the HIV epidemic are felt. This is where the Church exercises its pastoral ministry, where long-term Christian formation takes place, where Christian community is built, where people are brought to God and souls are saved. The caring church and the healing community: they are different models or paradigms, often using different vocabularies, different concepts, and different tests for truth. What is the goal: prevention of disease, or salvation?
Which is the problem: the virus or the sin? Which is more to be feared, death or damnation? Should responses be interventionist (pharmaceuticals, condoms) or moral (abstinence, faithfulness)? When people complain that the churches contribute to the rapid spread of HIV, then it is this second model, the soul-saving church and its leaders, that they have in mind. That is what leaders mean when they confess that they and their churches have 'contributed to death'2.
3. Silence and stigma: the biggest enemies
The biggest obstacle to HIV prevention is now generally acknowledged to be the stigmatisation of people living with or affected by HIV/AIDS, and the silence and denial it causes. Clergy with HIV have been dismissed from their jobs, shunned, and forced to marry again if they are widowed.
Religious leaders have "added to the misery of people living with HIV/AIDS by condemning them as 'wrong-doers' or 'sinners'," says a Ugandan study. People with HIV and their families have been excluded from churches, publicly exposed, refused pastoral care and funeral rites, and in extreme cases have been killed. Without a word from the churches, orphans have been thrown out of their homes, accused of being cursed, and either excluded from school or made to sit separately with other 'AIDS kids'.
Few people are willing to state that a relative has died of AIDS, and one study showed that less than one in ten home-care volunteers will admit that the person they are caring for has HIV/AIDS. One result is great suffering for people who are known to have HIV and their families. Another is massive reluctance, among people who fear they are infected, to come for help or to take steps to avoid passing the virus on.
Even in situations where antiretroviral treatment is available for pregnant women, mothers are often so afraid of stigmatisation that they will risk having an HIV-positive baby rather than come for testing themselves.